"They medicated me out": Social flesh and embodied citizenship in addiction treatment (2018)

Addiction, a cultural construct long framed in moral, psychological, and social terms, is increasingly understood as biological and treated with medications. In the United States, methadone, buprenorphine, and a variety of psychopharmaceuticals are now commonly used to treat addiction alongside long-standing approaches such as 12-Step mutual aid. These biomedical interventions reshape the very condition they intervene on, influencing the ways treatment clients understand and experience addiction. Clients often experience medication treatment in tension with embodied and social practices of addiction: bodily routines, sensory experiences, temporalities, and social contexts of use. This article examines these tensions through theories of the social flesh and embodied citizenship. This analysis is based on a 20-month ethnography in and around "Sunrise" residential center in Northeast Ohio. Sunrise merges biomedical interventions with 12-Step, psychological and juridical approaches. These data show how biomedical practices alter client bodies and subjectivities, promoting body alienation at stark odds with the intense bodily connection clients established through drug use. This alienation results from rapid weight gain and heavy sedation clients attribute to medication effects, as well as mandated medication and adherence practices that strip clients of a sense of control of medication use. Many clients describe feeling "medicated out" of life: estranged from treatment peers and kin who oppose medications, counselors and other powerful authorities who demand their undivided attention, and friends with whom they are unable to relate when heavily medicated. Clients, however, do not passively accept this estrangement. They alter their bodily experiences by leveraging embodied practices developed during drug use. Through practices such as selectively taking medications based on historical bodily experience and illegal drug "testing" in the underground economy, clients reassert bodily connection and control, deriving a modicum of power - albeit constrained and risky - in a treatment system that strictly limits it.